The Elms Residential Care Home

Updated 8 February 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out over two days by one inspector and on the first day, an Expert by Experience attended. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Elms Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We received feedback from the local authority and a professional who works with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and two relatives about their experience of the care provided. We spoke with six members of staff including the registered manager, an assistant manager, three care workers and the chef.

We reviewed a range of records. This included six people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management and monitoring of the safety and quality of the service were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found relating to quality assurance records.

Updated 8 February 2020

About the service

The Elms Residential Care Home is a care home providing personal and nursing care to people aged 65 and over. The service can support up to 20 people in one adapted building. At the time of the inspection, 18 people were living in the home, some of whom were living with dementia.

People’s experience of using this service and what we found

With the input from external stakeholders, the service had made positive changes since our last inspection, although some of our findings showed a need for further improvement in certain areas.

Specifically, the quality management systems in place had not been fully effective at identifying issues, partly because they were not comprehensive enough to ensure all aspects of the service were monitored. This included the regular review and analysis of incidents, accidents and near misses. It also included ensuring compliance with the service’s training policy and we have made a recommendation about this. Infection control checks had not identified issues uncovered during the inspection and care plan audits had failed to ensure some errors and omissions in care records were addressed.

People and their relatives spoke positively about the care they received at The Elms, which they told us was delivered by kind, attentive and friendly staff, who they knew well. People were treated with warmth and affection, they were listened to, valued as individuals and respected.

People told us they were supported to be involved in making decisions about their care and to retain their independence, where possible. They were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People’s care was personalised and delivered in a way that met their needs and preferences. Staff sought to ensure people were involved in activities and events that were of genuine interest to them. People were supported to have contact with relatives and friends and staff were alert to and took actions to avoid the potential for social isolation.

We heard and observed that staff were knowledgeable and able to care for people so they remained safe and well. People were supported to ensure their health needs were met and that their intake of food and fluids was appropriate to their needs. Where staff supported people with their medicines, they did so safely.

The registered manager led the service well and ensured a dedicated and caring culture developed. They engaged well with people using the service, relatives, health care professionals and other stakeholders and this promoted an inclusive and empowering environment.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Requires Improvement (last report published 22 November 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.